Effect Of Massed Practice Versus Distributed Practice On Basic Mobility Skills Among Post Stroke Patients

ABSTRACT

Background: Stroke a global health problem is the second commonest cause of death and fourth leading cause of disability. Bed mobility the most important requisite for all activities in impaired in stroke. Retraining of bed mobility skills is very important to gain better outcome in the later phases of rehabilitation. Based on the concepts of motor learning there are numerous practice methods to retrain motor skills. Since sufficient literatures are not available in comparing the effect of massed practice and distributed practice on bed mobility skills among post stroke patients, there is a need for incorporating it in this study. Objectives: To compare the effect of massed practice and distributed on basic mobility skills among post stroke patients. Materials and Methods: Study was conducted as a quasi experimental design – pretest and posttest designs with two comparison treatments at the Department of Physical Medicine and Rehabilitation ,KMCH Hospitals, Coimbatore, Tamil Nadu, India. A total of 20 stroke patients in the age group of 45 to 60 years participated in the study. The participants who satisfied the selection criteria were selected by convenience sampling and randomly assigned into two groups. Group A received bed mobility training using massed practice method and group B received bed mobility training using distributed practice method for 7 days. Outcomes were measured with bed mobility item of Stroke Rehabilitation Assessment of Movement (STREAM) scale. Results: All participants in group A and group B showed significant improvement in bed mobility item of STREAM scale with a mean difference of 11.2 and 15.9 respectively. The calculated ‘t’ value using the paired test for group A and B were 27.03 and 51.36 (P<0.005) respectively. When comparing between the groups using independent ‘t’ test, the bed mobility item of STREAM scores showed mean difference of 4.9 and ‘t’ value of 9.7 (P<0.005). Conclusion: This study revealed that there was significant improvement in bed mobility skills following distributed practice method than massed practice method among post stroke patients.